Treatment Holiday vs. Continuous Treatment?

Recent research has shown that patients do better when they keep taking their medication instead of taking breaks. This is known as continuous treatment vs. taking treatment holidays.1

Chemotherapy, which is a kind of cancer treatment, can have very unpleasant side effects and may cause harm to patients as well as making people uncomfortable or even sick. To reduce the impact of these side effects, doctors sometimes decide to give their patients a break, or a what’s known as a “treatment holiday,” from their medication. Some doctors or health care providers believe that treatment holidays may also help prevent desensitization, where the body gets used to a specific medicine and stops responding to it.2

Comparing treatment holiday and continuous treatment

A recent study looked into whether patients did better using treatment holidays or taking their medications continuously. The authors wanted to compare both the survival and quality of life of people being treated these different ways. The research was conducted by healthcare providers and their colleagues at the Zuyderland Medical Center in the Netherlands.1

“In clinical practice, we see considerable variation in treatment strategies, so felt it would be helpful to conduct a trial investigating the effect on the quality of life of scheduling with modern agents,” explained Dr. Anouk Claessens, one of the study authors.1

More about the study

The study was a trial for patients with advanced HER2-negative breast cancer.1 HER-2 refers to specific molecular characteristics of a breast cancer tumor. People with advanced disease have tumors that have spread beyond their original lump either to the lymph nodes or to other parts of the body.3

The study compared survival time and quality of life for patients receiving either 8 cycles of continuous therapy or 8 cycles of therapy with a “treatment holiday” between 4 cycles at the beginning of treatment and 4 cycles at the end of treatment. The researchers measured both overall survival rates and progression-free survival rates (the amount of time a patient lives after receiving treatment without the disease getting worse).1

Continuous treatment works better

The study showed that patients did better when they took continuous therapy instead of intermittent (stop and go) therapy with breaks. The same result held true for both physical and mental quality-of-life measures. It also held true for both older and newer classes of medication.

Commenting on the study, Professor Nadia Harbeck from the University of Munich, Germany, said, “Until now, we’ve only had evidence from older studies, with regimens no longer used, indicating that continuous chemotherapy in metastatic disease is better than shorter. The new Stop&Go data confirm these older data also with more modern regimens.”

Even quality of life is better on continuous treatment

Not only did people live longer on continuous treatment, but their quality of life was better. That result is especially important because improving the quality of life is often why doctors choose treatment holidays in the first place.

As Professor Harbeck said, “the result that continuous chemotherapy is not at all associated with worse quality of life is clinically meaningful and further highlights the importance of preferring to administer chemotherapy continuously for benefiting the most our patients with advanced disease.”4

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